One of the original challenges facing NH DHHS was a lack of home health
clinician knowledge about smoking cessation resources for patients, and clinician
uncertainty about how to approach the subject with them.

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Through the New England QIN-QIO’s partnership with the NH DHHS, 11 home
health agencies were connected to the New Hampshire Tobacco Prevention
and Cessation Program. A tobacco treatment specialist offered to provide
on-site education at the agencies to increase awareness among clinical staff
about the health risks of smoking. The partners worked to connect clinical
staff directly with patients.

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“We are connecting patients with resources that we never knew were available."

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Cornerstone VNA, a home
health agency serving 35 communities in southern New Hampshire and Maine,
spearheaded the smoking cessation initiative within its organization. A key
manager at Cornerstone VNA was identified to enter patient data into the Home Health Quality Improvement (HHQI)
National Campaign’s Home Health Cardiovascular Data Registry. Initially it was
challenging for the manager to identify appropriate resources and the steps
necessary to accomplish the goals. To help streamline the process, home health
staff at the New England QIN-QIO created the “Road Map
to Success Implementation Checklist” tool to help agencies better
navigate the registry and its deadlines.

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To implement the smoking cessation initiative, a dedicated quality
improvement team at Cornerstone VNA identified the data needed based on the quality improvement measure it chose. In particular, team members needed to collect two pieces of
information: whether the patient had been screened for tobacco use and
whether smoking cessation education had been provided for at least three
minutes. Once this data was collected, Cornerstone VNA was able to implement
specific clinician interventions into a patient's care plan.

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Through
the New Hampshire Tobacco Prevention and Cessation Program, Cornerstone VNA
received a customized referral form to refer patients to the New Hampshire Tobacco Helpline. The
program also provides smoking cessation patient education booklets, which the
New England QIN-QIO shares with providers. “We
are connecting patients with resources that we never knew were available.
Clinicians are more comfortable asking about smoking cessation with patients
and connecting them with the resources they need to be successful,” said
Jennifer Gullison, RN, MSN, Clinical Director at Cornerstone VNA.

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Cornerstone VNA closely monitors HHQI data on a monthly basis to identify what
additional education is needed for its patient population. The staff educator
at Cornerstone VNA brings concerns to the clinical director and works to
reeducate staff – all of whom are trained on the initiative – when they see
numbers begin to rise. Since implementing the initiative, 100 percent of
Cornerstone VNA patients have been screened, and patients who agreed to quit
smoking have received education and resources.